Doctor Name: | MRS. BETH CAROL THEISEN |
NPI Number: | 1548370984 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D., CDE |
License Number: | R014448 |
Business Practice Address: | 22151 Moross Rd Pb 1, Suite 228, Diabetes Education Detroit, MI - 482362167 |
Business Phone Number: | 3133434181 |
Business Fax Number: | 3133437326 |
Mailing Address: | 22151 Moross Rd, Pb 1, Suite 228, Diabetes Education DETROIT |
State: | MI |
Postal Code: | 482362167 |
Phone Number: | 3133434181 |
Fax Number: | 3133437326 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | R014448 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |